Ulcerative Colitis Resource Center

Ulcerative Colitis Resource Center

June 27, 2018
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Dose intensification helps restore response to Entyvio

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Dose intensification helped restore response to Entyvio in patients with inflammatory bowel disease, according to research published in Clinical Gastroenterology and Hepatology.

Stefanos Bonovas, MD, MSc, PhD, of the department of biomedical sciences at Humanitas University in Milan, Italy, and colleagues wrote that their findings could help guide future research to help clinicians understand which patients would benefit the most from dose intensification.

“Over the last 20 years, monoclonal antibodies have changed the way to treat refractory inflammatory bowel disease,” the researchers wrote. “Anti-TNF agents have a well-established efficacy for the use as maintenance therapy in both Crohn’s disease and ulcerative colitis. However, a proportion of patients lose response over time.”

Bonovas and colleagues conducted a meta-analysis to determine the incidence rates of loss of response to Entyvio (vedolizumab, Takeda Pharmaceuticals) during maintenance therapy, as well as if dose intensification can restore response to the drug.

In determining incidence of the loss of response, investigators identified seven patient cohorts that underwent vedolizumab maintenance therapy in which 460 patients were followed for approximately 365 person-years of maintenance.

Researchers found pooled incidence rates of loss of response of 47.9 per 100 person-years of follow up among patients with CD (95% CI, 26.3–87) and 39.8 per 100 person-years of follow up among patients with UC (95% CI, 35–45.3).

Bonovas and colleagues found four studies that reported data on the efficacy of vedolizumab intensification. They found that 56 out of 111 secondary non-responders achieved response after intensification (pooled efficacy rate = 53.8%; 95% CI, 21.8–82.9).

The researchers wrote that future randomized controlled trials could help define the role of therapeutic drug monitoring in finding patients who would benefit the most from this kind of dose intensification.

“Loss-of-response to vedolizumab maintenance therapy represents a clinically important problem that affects a considerable proportion of patients with CD and UC,” they wrote. “Future studies need to focus on the identification of biomarkers that predict response to the different treatment options in IBD, in order to optimize patient selection and refine treatment algorithms.”– by Alex Young

Disclosures: Bonovas reports no relevant financial disclosures. Please see the full study for the other authors’ relevant financial disclosures.